All About Paediatric Pancreatitis In Children

Childhood pancreatitis is rare and can be caused by trauma or hereditary factors. Parents often wonder if certain foods could have triggered their child's pancreatitis and if a special diet could help manage the symptoms or prevent future episodes.

In this article, we will discuss all about pancreatitis and provide dietary recommendations for children with this condition.

What is Pancreatitis?

Pancreatitis is an inflammation of the pancreas. It can cause stomach-like symptoms, including abdominal pain, vomiting, and nausea.

The majority of pancreatitis cases resolve on their own.

What is the Function of the Pancreas?

The pancreas is a large gland located behind the stomach.

• It secretes digestive enzymes into the small intestine to aid in the digestion of food.
• The pancreas also produces insulin and glucagon, two hormones that help regulate blood sugar.

Types of Pancreatitis

• Acute Pancreatitis: lasts for a few days and is common in children who experience only one episode
• Chronic Pancreatitis: enduring for an extended time and may cause irreversible pancreatic damage

What Symptoms and Signs Are Associated with Pancreatitis?

Pancreatitis in children is characterized by sudden, severe upper abdominal pain, and they may also experience back, chest, or side pain.

Other symptoms of pancreatitis include:

• fever
• irritability
• loss of appetite
• nausea and vomiting

Chronic pancreatitis in children may have symptoms such as:

• diarrhea
• Greasy feces that are challenging to flush.
• poor blood sugar control (high blood sugar or low blood sugar)
• weight loss and inadequate growth

Some children who suffer from recurrent acute pancreatitis may develop chronic pancreatitis.

What Causes Pancreatitis?

• Certain medicines
• Extremely high triglyceride levels
• Gallstones or issues with the pancreatic or hepatic ducts can be fatal (tubes)
• Genetic or inherited disorders
• Infections
• Traumatic abdominal injury

Certain diseases and conditions, such as cystic fibrosis and celiac disease, can increase the risk of pancreatitis in children.

In rare instances, the cause of pancreatitis cannot be determined.

Pancreatitis Diagnosis

• Blood tests (amylase and pancreatic lipase measurements) are ordered to diagnose pancreatitis.
• Abdominal ultrasound is used to examine the liver and pancreas and look for gallstones if enzyme levels are elevated.
• CT scan or MRI can detect inflammation or damage to the pancreas in addition to other tests.

How Is Pancreatitis Treated?

• In most cases, pancreatitis resolves within a week without treatment.
• Nausea and vomiting can be treated with analgesics and antiemetics as the pancreas heals.
• Severe pancreatitis requires hospitalization with intravenous fluids and pain medication.
• Mild pancreatitis patients can begin eating immediately while severe cases require formula via feeding tube or TPN.
• ERCP may be required for a subset of children to remove gallstones and identify other causes.
• A healthy diet, avoiding certain foods, and limiting simple sugars and carbohydrates is recommended for all patients.
• A low-fat diet may help alleviate symptoms in children with hypertriglyceridemia, but it is not scientifically proven to be effective in reducing the likelihood of developing pancreatitis.

Diet Recommendation For Paediatric Pancreatitis

A healthy diet and avoiding certain foods can be beneficial for children with or without pancreatitis. For those experiencing acute episodes or in the middle of an episode, following these tips may be helpful:

• Increase intake of fruits and vegetables (about half the plate).
• Choose whole grains instead of simple carbs.
• Ideally, protein should make up one-fourth of the plate.
• Limit intake of simple sugars and carbohydrates (such as juice, cookies, chips, etc.).
• Stop eating when feeling full.

Note: Doctors only recommend a specific diet for children with high blood triglyceride levels (hypertriglyceridemia). A low-fat diet was previously suggested to reduce the risk of developing pancreatitis, but this has not been scientifically proven. The pancreas produces lipase, which helps digest fat, and high levels of lipase may indicate pancreatic inflammation.

Important Information about Pancreatitis in Children

• Most children recover from acute pancreatitis without complications, although fluid accumulation may require drainage.
• Children with chronic pancreatitis may require pancreatic enzyme supplements for digestion and may develop diabetes over time.
• Chronic pancreatitis increases the risk of developing pancreatic cancer in children compared to the general population.
• The level of risk depends on the underlying cause of pancreatitis and should be discussed with a doctor.

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